Paula Tironi, JD, LLM and Monique M. Karaganis, MD
While parents often have legal authority to make decisions regarding pediatric palliative care, federal and state statutory and case laws, like CAPTA, impose significant restrictions on that authority.
The participatory decision-making model for patient-physician relationships is the best approach for addressing the individual family-related and social influences that stress that relationship.
Pairing medical students with chronically ill community volunteers for 2 years helps those students gain appreciation for the experience of illness, develop self-reflection and perspective-taking, and learn to communicate with people who may be quite unlike them.
Advance directives do not always resolve questions about the best care for patients who no longer have decision-making capacity; physicians and patient surrogates can take alternative approaches to arrive at the best care decision.
Clinical and psychosocial considerations influence how oncologists approach discussing sperm banking with adolescent patients who are about to undergo chemotherapy and with the parents of those patients.